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Richard Paxman was just 10 years old when his own mother developed terminal breast cancer. As the sons of the man who invented the beer cooler, Richard’s father Glenn Paxman, along with his uncle Neil, dedicated themselves to using the family’s refrigeration business as inspiration and in 1997 developed a scalp cooling system to help prevent others from experiencing the devastating effects of hair lossduring her chemotherapy.

Now, with Richard as the Yorkshire-based firm’s CEO, scalp cooling pioneers Paxman supply over 80 per cent of the UK’s NHS and private hospitals with cold caps for use during cancer treatment and are set to expand into the US market.

Why cancer treatments cause hair loss

Speaking to News Medical, Richard Paxman outlined precisely why chemotherapy cancer treatment can cause people to lose their hair, and how it can affect patients.

“The basic principle of chemotherapy is to damage the mitotic and metabolic processes in the cancer cells. The chemotherapy doesn’t just target the cancer cells, it also targets the healthy cells, specifically ones that are rapidly dividing – our hair follicles are also rapidly dividing.” In fact, at any given time, 90 per cent will be in the actively dividing phase of the hair growth cycle, also known as the anagen phase.

“We see damage to those hair cells, which then causes the hair to fall out,” he explains. Adding that this is not the case with all chemotherapies: “…generally, with taxanes and anthracycline-based therapies, you will see complete hair loss. It happens quite rapidly…”

Chemotherapy-related hair loss is caused by partial or complete degeneration of the hair root bulb as this deprives the hair shaft of nutrients, weakening them and leading to hair breakage and hair fall. When a number of follicles are affected at once – as is the case with chemo – the effect can be shocking due to the amount of hair falling out at once.

This hair loss can hit cancer patients hard as it is a physical sign and constant reminder of their illness. Unsurprisingly many patients find it incredibly distressing which is why cold caps, which are worn for 30 minutes before, during and then for 90 minutes after chemotherapy sessions to help prevent this shedding, are proving so popular. Furthermore, there is a low incident rate for long term side effects, currently considered to be less than 2.5 per cent.

Keen to dispel rumours about why people choose to use scalp cooling technology whilst undergoing chemo, Richard says: “…a lot of people often think it could be vanity and it is certainly not. We have seen that depression and stress can actually cause negative clinical results. If a patient has a weakened immune system due to depression and stress, this often means they don’t get as well as they should do.”

“We’ve also seen that 1 in 12 or 8% of patients actually refuse chemotherapy because of hair loss. If we can stop that patient population from not going ahead with the chemo and make sure they do have the right drugs, then that alone has a massive impact on patient outcome.”

How cold caps work

Cell division, including that which occurs during hair growth, is driven by the metabolism and cold cap technology is based on the fact that the metabolism can be slowed down by cooling.

According to the company’s literature, Paxman’s process of scalp cooling causes the blood vessels in the area being chilled to constrict, thereby reducing blood flow to the scalp by ’20-40% of the normal rate’. This primarily inhibits the spread of chemotherapy drugs in the bloodstream from reaching the scalp and thereby preventing hair loss. However, Paxman states ‘It is also suggested that reduced biochemical activity due to cooling makes hair follicles less vulnerable to the damage of chemotherapy agents’.

“You also see a drop in metabolic rates, so cell division is reduced,” explains Richard. “You see less drug diffused through the cell membrane, meaning the chemotherapy is less targeted to the hair cells. All these factors combined make the chemotherapy less effective locally on the hair follicles, so it doesn’t damage them.”

The temperature at which cold caps have been found to function most effectively for hair loss prevention is below 22°C, often 18°C. These low temperatures, which can sometimes lead to ice forming inside the lightweight silicone helmets, explains why the device’s short-term side effects can include discomfort from the cold, headaches and possible dizziness during and straight after each chemo session.

Paxman is currently looking into new ways to improve its delivery system with personalised caps for the best possible fit on every head shape being a priority. The company has also been working with Huddersfield University on in vitro studies to see how and when cooling affects hair follicles, in order to get a better understanding of what it does “on a basic biological level“.

Whilst in the great majority of cases patients’ hair will grow back naturally in around 12 months following chemo, it is hoped that through on-going research and partnerships such as this one Paxman’s development team may be able to increase efficacy rates meaning more cancer patients worldwide will get to keep their hair in the first place.

The Belgravia Centre

The Belgravia Centreis the leader in hair loss treatment in the UK, with two clinics based in Central London. If you are worried about hair loss you can arrange a free consultation with a hair loss expert or complete our Online Consultation Form from anywhere in the UK or the rest of the world. View our Hair Loss Success Stories, which are the largest collection of such success stories in the world and demonstrate the levels of success that so many of Belgravia’s patients achieve. You can also phone 020 7730 6666 any time for our hair loss helpline or to arrange a free consultation.